Diabetes
Notes for newly diagnosed Type 2 Diabetes Mellitus
History
Symptoms
Glycosuria
Hyperglycemia
Predisposing
Age
Family history
Cultural group (higher risk – Aboriginal and Torres Strait Islanders, South Pacific Islands, Southern Europe, Eastern Europe and Central Asia, the Middle East, North Africa and Southern Asia)
Overweight
Physical inactivity
Hypertension
Gestational diabetes, or a history of large babies
Medications causing hyperglycaemia e.g., antipsychotics, corticosteroids
Personal or family history of haemochromatosis
Auto-immune diseases
Risk factors for complications
Personal or family history of cardiovascular disease
Hypertension
Smoking
Dyslipidaemia
Lifestyle issues
Smoking
Nutrition
Alcohol
Physical inactivity
Occupation
General symptom review including
Cardiovascular symptoms
Neurological symptoms
Bladder and sexual function
Foot and toe problems
Recurrent infections, particularly urinary and skin
Vision
Examination
BMI and waist circumference
Cardiovascular system:
Blood pressure, lying and standing
Peripheral and neck vessels
Eyes:
Visual acuity (with correction)
Cataracts
Retinopathy (examine with pupil dilation)
Feet:
Sensation and circulation
Skin condition
Pressure areas
Interdigital problems
Abnormal bone architecture
Peripheral nerves:
Tendon reflexes
Sensation:
Touch (10 g monofilament)
Vibration (128 Hz tuning fork)
Urinalysis:
Albumin
Ketones
Nitrates and/or leucocytes
Investigations
Baseline:
Renal function – eGFR, urinary albumin creatinine ratio (ACR)
Lipids – LDL-C, HDL-C, Non-HDL-C, total cholesterol, triglycerides
HbA1c
Also consider:
ECG if patient aged > 50 years and ≥ 1 other vascular risk factor
TSH if there is a family history or clinical suspicion of thyroid disease
Cardiovascular
Complete a Cardiovascular (CV) Risk Assessment
Management
Consider seeking urgent advice if
Persistent or severe hyperglycaemia (> 20 mmol/L)
HbA1c > 97 mmol/mol (11%)
Presence of ketonuria or ketonaemia (> 0.6 mmol/L)
Severe hypoglycaemia requiring third party assistance
Frequent hypoglycaemia (3 or more hypoglycaemic episodes per week)
If pregnant and diabetic, escalate care
Explanation of diabetes
Healthy Eating
Diabetes Australia:
NDSS:
Hunter New England Local Health District / NSW Health resources:
Increased physical activity
Advise patients to:
aim for 30 minutes of moderate intensity physical activity such as brisk walking on most days.
increase activity time to 60 minutes per day, when possible.
reduce inactivity and avoid sitting for extended periods e.g., TV watching (even standing uses more energy).
Help the patient find an activity that fits in with their lifestyle and is sustainable. Undertaking physical activity with others is often more enjoyable.
Any increase in activity, however small, is a positive step. "Snacks" of activity, for example 3 x 10 minutes daily may have some value.
Provide patients with a Diabetes Australia Physical Activity fact sheet.
Weight reduction
Weight reduction is an important target for most people with diabetes or prediabetes.
Most people achieve weight loss after following healthy eating guidelines and increasing exercise.
If the patient is overweight or obese, aim for a weight loss of 0.5 to 1 kg per week and a long-term loss of 5% of initial weight – but acknowledge any degree of loss as a success.
Staying the same weight may be a meaningful achievement for some individuals.
See also:
Get Healthy, phone 1300‑806‑258 (Monday to Friday) – free personal telephone health coaching
Glycaemic targets
HbA1c target – individualise according to patient circumstances. Generally ≤ 7.0% (53 mmol/mol).
Goals may be lower (6.5%) in patients:
without overt cardiovascular disease.
with a shorter duration of the disease.
on controlled diets.
on treatment with low risk of hypoglycaemia (metformin, DPP-4 inhibitors, SGLT2 inhibitors, and GLP-1 agonists). See Diabetes Medications.
with a lower baseline HbA1c.
Goals may be higher in patients who:
are aged > 65 years.
have co-morbidities.
are at risk of adverse drug effects e.g., hypoglycaemia causing confusion, falls and fractures, renal dysfunction, alcoholism.
Discuss the BGL goals with patients as they may vary according to:
risk of hypoglycaemia (e.g., frail or elderly), or impairment of quality of life.
presence of pre-existing cardiovascular disease or other high-risk factors e.g., hypertension, dyslipidaemia.
Blood glucose goals – individualise according to patient circumstances. Generally:
5 to 7 mmol/L fasting.
< 10 mmol/L post-prandial.
Glycaemic management
Seek urgent diabetes specialist assessment if:
persistent or severe hyperglycaemia (> 20 mmol/L).
HbA1c > 97 mmol/mol (11%).
presence of ketonuria or ketonaemia (> 0.6 mmol/L).
For all other patients – if the patient is:
symptomatic, initiate glucose lowering medication.
asymptomatic:
trial lifestyle modification as first-line management.
start glucose lowering medication if HbA1C target is not reached within 3 months.
If medication is required:
Metformin is first-line unless contraindicated or not tolerated, even if not overweight.
Start with low dose (e.g. 500 mg daily) to reduce gastrointestinal intolerance.
Titrate to maximum tolerated dose within 2 to 3 months.
Second-line agents may be necessary and should be chosen using an individualised approach. See Diabetes Medication.
Monitor HbA1C:
every 3 months if glycaemic targets not met or following treatment changes.
every 6 months if glycaemic targets achieved.
Monitor blood glucose if clinically indicated
Screening
Arrange appropriate monitoring and screening as per chronic disease management plan (Medicare provides specific item numbers). Offer patients a diabetes management record card.
Dental Check
Immunisations
Influenza – once a year.
Pneumococcal:
For patients with conditions that increase the risk of pneumococcal disease:
Give patients aged > 12 months 1 dose of 13vPCV at diagnosis and 2 lifetime doses of 23vPPV.
Give 23vPPV 2 to 12 months later, or at age ≥ 4 years, whichever is later.
Give 2nd dose of 23vPPV at least 5 years later (not funded on NIP).
Give all Aboriginal and Torres Strait Islander patients aged ≥ 50 years 1 dose of 13vPCV and 2 doses of 23vPPV (funded on NIP).
Consider using the PneumoSmart Vaccination Tool to assist in calculating adult dosing schedule and funding eligibility.
See also:
National Immunisation Program – Pneumococcal Vaccination schedule from 1 July 2020: Clinical Decision Tree for Vaccination Providers.
Australian Technical Advisory Group on Immunisation (ATAGI) – ATAGI Clinical Advice on Changes to Recommendations for the Use and Funding of Pneumococcal Vaccines from 1 July 2020.
National Immunisation Program – Pneumococcal Vaccination schedule from 1 July 2020: Clinical Advice for Vaccination Providers.
Tetanus – booster at age 50 (unless booster has been given within 10 years). In adults, it is best given with a multivalent vaccine such as dTpa (Boostrix or Adacel, or Boostrix‑IPV or Adacel‑Polio).
Herpes Zoster vaccine (Zostavax) – provided free to patients aged ≥ 70 years unless contraindicated. There is a 5‑year catchup program for people aged 71 to 79 years.
Other considerations and supports:
Consider fitness to drive.
Fitness to drive
Hypoglycaemia, lack of hypoglycaemia awareness, complications such as CV disease, retinopathy, neuropathy and foot problems can affect fitness to drive.
Patients should be advised of the effects of their condition on driving, and advised of their legal obligation to notify the driver licensing authority when driving is likely to be affected.
Under AustRoads guidelines, commercial drivers must be reviewed annually by a diabetes specialist.
For detailed information, refer to AustRoads – Assessing Fitness to Drive.
Complete NDSS registration to reduce cost for diabetes products, and allow access to additional resources. Patients receive a starter pack on registration.
NDSS registration
NDSS registration forms are available either:
online via the Health Professional Portal: processed and confirmed within minutes if all the information is supplied, or
as a downloadable hard copy: scan and email to info@ndss.com.au or fax 1300‑536‑953 once completed. Adhere to RACGP's Using Email in General Practice fact sheet guidance.
Consider recalls for regular follow up.